Ear infections can occur as several different types: otitis externa, acute and chronic otits media, and inner ear infections, all of which may occur in adults and children. Adults and children have many symptoms in common, although sometimes the symptoms differ.
Difficulty Hearing
Because, in many ear infections, the eardrum (tympanic membrane), cannot vibrate, the ear loses it capacity to respond to sound. Sometimes the patient will turn up the volume on the television or radio or favor one ear over the other. In children, difficulty hearing is manifested in difficulty hearing sounds coming from the direction of the affected ear. In serous otitis media (otitis media with effusions), hearing can be decreased to the extent that it interferes with language skills. Difficulty hearing may be the only symptom in young children.
In otits externa, there is no difficulty hearing.
In inner ear infections, hearing loss is often present. Hearing loss is generally not found in children with viral labyrinthitis. It may, however, be found in viral labyrinthitis associated with mumps, measles, cytomegalovirus and rubella. Severe vertigo and sudden hearing loss is associated with bacterial labyrinthitis.
Otorrhea
When the middle ear is infected, pus and fluid may accumulate behind the eardrum. If the eardrum ruptured as a result of the pressure of the fluid behind the eardrum, the pus and fluids flow through the ear canal and out of the ear as a discharge. This discharge may be clear or pus-like. This symptom is seen in adults and children. It is not seen in otits externa or inner ear infections.
Otalgia
Associated with outer and middle ears infections, otalgia may be associated with conditions not related to the ear. Both children and adults have ear pain. Ear pain and itching occurs in otits externa. Otaligia is not associated with inner ear disease, nor is it a symptom of chronic supperative otits media, a chronic condition where there is continuous or intermittent pus-like discharge from the ear. Rupture of the eardrum is associated with a sudden decrease in the aching pain associated with ear infection in children and adults and is usually followed by a discharge from the ear.
Aural Pressure
Fullness, similar to the sensation that you get when you take off or land in an airplane, is common in ear infections in children and adults. When the Eustachian tube, the tube that connects the middle ear with the nasopharynx, is blocked, the pressures in the middle ear and the outside air cannot equilibrate.
Irritability and Ear Pulling
As a result of the pain associated with otitis media or when the ear feels blocked, a child may become irritable and pull or scratch at the ear. Adults may become irritable but are acutely aware of the pain associated with otitis media.
Vertigo and Tinnitus
When the inner ear is infected, symptoms related to loss of balance are present. Vertigo, the sense that the room is spinning when it is not, is common. In viral labyrinthitis, which is associated with a viral illness or upper respiratory tract infection, worsening dizziness and sudden vertigo are common features. Severe vertigo may be seen in bacterial labyrinthitis, and it may be accompanied by nystagmus (the inability to track an object with the eyes smoothly), hearing loss and tinnitus.
Children may appear to have problems with balance, and adults may have difficulty with balance.
Other Signs
Fever, nausea and vomiting are systemic signs of many ear infections. Fever is common in many infections and is seen in both children and adults. Nausea is seen in conditions that affect the inner ear and may occur with vomiting, often seen in children.
References
- Cecil Medicine 23rd Edition
- eMedTV: Ear Infection Symptoms
- Medline Plus: Labyrinthitis
